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Purpose: Wholegrain intake is linked to lower risk of lifestyle diseases, but little is known about its role in growth and metabolic health during the first years of life. We characterized wholegrain and dietary fibre intake in 439 Danish children at 9 and 36 months of age and explored associations with height z-scores (HAZ), body mass index z-scores (BMIZ) and metabolic markers. Methods: We used pooled data from two infant cohorts and estimated intakes of total wholegrain, dietary fibre and wholegrain subtypes from 7-day dietary records. Associations with HAZ, BMIZ and non-fasting plasma low-density (LDLC) and high-density-lipoprotein cholesterol, triacylglycerol, insulin and glucose were analysed in mixed models, adjusted for potential confounders. Results: Median (25th, 75th percentile) wholegrain intake was 7.5 (4.9, 10.5) and 6.5 (4.6, 9.0) g/MJ at 9 and 36 months. Neither wholegrain nor dietary fibre intake were associated with HAZ (P ≥ 0.09). At 36 months, wholegrain intake was inversely associated with LDLC (P = 0.05) and directly with glucose (P < 0.001). In secondary analyses, wholegrain rye was inversely associated with glucose at 9 months and insulin at 36 months (both P ≤ 0.03). Oat and wheat wholegrain were directly associated with glucose (both P ≤ 0.01) and wheat with BMIZ (P = 0.02) at 36 months. Conclusion: Danish infants and toddlers have high intakes of wholegrain and dietary fibre, with no indication of compromised growth. In line with studies in adults, wholegrain intake was inversely associated with LDLC. The observed direct association between wholegrain intake and plasma glucose and associations with wholegrain subtypes should be investigated further. [ABSTRACT FROM AUTHOR]

Purpose: We assessed the effect of the current iodine fortification level (20 µg/g household salt and salt included in bread and bakery products) on inadequate and excessive intake in the general Danish population. Intake models with/without the contribution from food supplements and effects of excluding specific food groups were evaluated. Method: Data from the Danish National Survey of Dietary Habits and Physical Activity in 2011–13 (N = 3946, aged 4–75 years) stratified by age-group and sex were used to estimate habitual dietary iodine intakes, and compared with established dietary reference values. Results: The proportion with an estimated inadequate iodine intake was ≤ 3% for males and ≤ 5% for females, except for 15–17-year-old girls, where the probable prevalence of an inadequate intake was 11%. Including the contribution from food supplements gave similar results (10%). High intakes (as defined by 95th percentile) from food sources generally did not exceed the tolerable upper intake level (UL). However, for the youngest age-groups (4–6-year-old boys/girls and 7–10-year-old boys), the 95th percentiles exceeded the UL with 11%, 4% and 7%, respectively, when food supplements were included in the estimates. Especially exclusion of dairy products and bread led to an inadequate intake for both boys and girls. Conclusion: The current fortification level may provide an inadequate iodine intake for some females and on the other hand lead to excessive intakes in the youngest age-groups. The study shows the importance of choosing iodine-rich alternatives when excluding major sources of iodine in the Danish diet. [ABSTRACT FROM AUTHOR]

Purpose: Diet quality is increasingly recognized as important for human reproductive capacity. We studied the association between intake of protein-rich foods and risk of spontaneous abortion (SAB). Methods: During 2013–2020, we recruited pregnancy planners from the United States and Canada (Pregnancy Study Online; PRESTO) and Denmark (SnartForaeldre.dk; SF). Participants completed a baseline questionnaire and a validated cohort-specific food frequency questionnaire. We estimated preconception intake of red meat, poultry, processed meat, seafood, eggs, plant-based proteins, and dairy from individual foods and mixed recipes. We included 4,246 PRESTO and 2,953 SF participants who reported a pregnancy during the study. Data on SAB were derived from questionnaires and population registries. We used Cox proportional hazards regression to estimate hazard ratios (HRs) and 95% confidence intervals (CI), representing the effect of substituting one type of protein-rich food for another. Results: SAB risk was 23% in PRESTO and 16% in SF. In PRESTO, substitution of seafood with other protein-rich foods was associated with higher SAB risk [for example, the HR for replacing 100 g of seafood/week with 100 g of red meat was 1.10 (95% CI 1.00, 1.20)]. In contrast, in SF, substituting seafood with other protein-rich foods was associated with lower SAB risk [HR for replacing 100 g of seafood/week with 100 g of red meat was 0.89 (95% CI 0.82, 0.98)]. Other protein-rich food substitutions were not meaningfully associated with SAB risk. Conclusions: Preconception intake of protein-rich foods was largely unrelated to SAB risk, with the exception of seafood, which was associated with higher risk of SAB in Denmark, but a lower risk in North America. [ABSTRACT FROM AUTHOR]

Specific types of dairy products may be differentially associated with atherosclerotic cardiovascular disease (CVD). We conducted a systematic review and meta-analysis of cohort studies to summarize findings on the associations between total dairy product intake and intake of dairy product subgroups and the risk of major atherosclerotic CVDs in the general adult population. Our protocol was registered in PROSPERO (CRD42019125455). PubMed and Embase were systematically searched through 15 August 2019. For high versus low intake and dose–response meta-analysis, random-effects modelling was used to calculate summary risk ratios (RR). There were 13 cohort studies included for coronary heart disease (CHD), 7 for ischemic stroke and none for peripheral artery disease. High-fat milk was positively associated with CHD (RR 1.08 (95% confidence interval 1.00–1.16) per 200 g higher intake/day) and cheese was inversely associated with CHD (RR 0.96 (95% confidence interval 0.93–0.98) per 20 g higher intake/day). Heterogeneity, however, was observed in high versus low meta-analyses. Milk was inversely associated with ischemic stroke in high versus low meta-analysis only. In conclusion, this systematic review indicates a positive association of high-fat milk and an inverse association of cheese with CHD risk. The findings should be interpreted in the context of the observed heterogeneity. [ABSTRACT FROM AUTHOR]

Background/objectives: Excessive intake of sodium is a dietary risk factor for morbidity and mortality. Currently, intake of sodium is much higher than the recommended level in most western countries, and effective strategies to reduce population sodium intake are lacking. The objective of the present study was to investigate the effect of two different sodium reduction strategies on the intake of sodium, potassium, and the sodium to potassium ratio among Danish families SUBJECTS/METHODS: The study was a 4-month, single-blinded, cluster randomized controlled trial with a parallel design. Eighty-nine healthy Danish families, with a minimum of one child and one parent (n = 309), were randomly assigned to receive sodium-reduced bread (Intervention A), sodium-reduced bread and dietary counseling (Intervention B) or regular sodium bread (Control). The primary outcome was change in daily sodium intake, measured by 24-h urinary sodium excretion. Secondary outcomes included changes in dietary potassium and the sodium to potassium ratio.Results: No significant differences in daily sodium intake were observed in the two intervention groups compared with the control. When analyzing the results separately for children and adults, a reduction in dietary sodium of 0.6 g/day (-1.0, -0.2), p = 0.005 occurred among adults in intervention B compared with control.Conclusions: This study demonstrates that providing sodium-reduced bread in combination with dietary counseling is an effective strategy to reduce dietary sodium among adults, but the effect is lacking in children. The study was not able to show significant effects when providing sodium-reduced bread alone in neither adults nor children. [ABSTRACT FROM AUTHOR]

Purpose: Public health policies and actions increasingly acknowledge the climate burden of food consumption. The aim of this study is to describe dietary intakes across four European countries, as baseline for further research towards healthier and environmentally-friendlier diets for Europe. Methods: Individual-level dietary intake data in adults were obtained from nationally-representative surveys from Denmark and France using a 7-day diet record, Italy using a 3-day diet record, and Czech Republic using two replicates of a 24-h recall. Energy-standardised food and nutrient intakes were calculated for each subject from the mean of two randomly selected days. Results: There was clear geographical variability, with a between-country range for mean fruit intake from 118 to 199 g/day, for vegetables from 95 to 239 g/day, for fish from 12 to 45 g/day, for dairy from 129 to 302 g/day, for sweet beverages from 48 to 224 ml/day, and for alcohol from 8 to 15 g/day, with higher intakes in Italy for fruit, vegetables and fish, and in Denmark for dairy, sweet beverages and alcohol. In all countries, intakes were low for legumes (< 20 g/day), and nuts and seeds (< 5 g/day), but high for red and processed meat (> 80 g/day). Within countries, food intakes also varied by socio-economic factors such as age, gender, and educational level, but less pronounced by anthropometric factors such as overweight status. For nutrients, intakes were low for dietary fibre (15.8–19.4 g/day) and vitamin D (2.4–3.0 µg/day) in all countries, for potassium (2288–2938 mg/day) and magnesium (268–285 mg/day) except in Denmark, for vitamin E in Denmark (6.7 mg/day), and for folate in Czech Republic (212 µg/day). Conclusions: There is considerable variation in food and nutrient intakes across Europe, not only between, but also within countries. Individual-level dietary data provide insight into the heterogeneity of dietary habits beyond per capita food supply data, and this is crucial to balancing healthy and environmentally-friendly diets for European citizens. [ABSTRACT FROM AUTHOR]

Purpose: Celiac disease, an immunological response triggered by gluten, affects ~1 % of the Western population. Information concerning gluten intake in the general population is scarce. We determined intake of gluten from wheat, barley, rye and oat in the Danish National Survey of Diet and Physical Activity 2005-2008. The study population comprised a random cross-sectional sample of 1494 adults 20-75 years, selected from the Danish Civil Registration System. Methods: Protein content in wheat, rye, barley and oat was determined from the National Danish Food Composition Table and multiplied with the amount of cereal used in recipes. Amount of gluten was calculated as amount of cereal protein ×0.80 for wheat and oat, ×0.65 for rye and ×0.50 for barley. Dietary intake was recorded daily during seven consecutive days in pre-coded food diaries with open-answer possibilities. Results: Mean total gluten intake was 10.4 ± 4.4 g/day (10th-90th percentiles; 5.4-16.2 g/day), in men 12.0 ± 4.6 g/day and 9.0 ± 3.4 g/day in women. It was higher among men than among women in all age groups (20-75 years; P < 0.0001); however, this difference was eliminated when adjusting for energy intake. Intake of different gluten sources tended to be higher in men than in women with the exception of gluten from barley. Total gluten intake decreased with increasing age ( P < 0.0001) as did gluten intake from wheat ( P < 0.0001), whereas intake of gluten from rye ( P < 0.0001) and barley ( P = 0.001) increased with increasing age, also when adjusted for energy intake or body weight. Conclusion: This study presents representative population-based data on gluten intake in Danish adults. Total gluten intake decreased with increasing age. [ABSTRACT FROM AUTHOR]

Purpose: To test the feasibility of tools and procedures for a pan-European food consumption survey among children 0-10 years and to recommend one of two tested dietary assessment methods. Methods: Two pilot studies including 378 children were conducted in Belgium and the Czech Republic in the Pilot studies for Assessment of Nutrient intake and food Consumption among Kids in Europe. One protocol included a 3-day food diary which was checked with a parent, and data were entered afterwards using EPIC-Soft. The alternative protocol consisted of two non-consecutive 1-day food diaries followed by EPIC-Soft completion interviews. Both protocols included general and food propensity questionnaires and anthropometric measurements. The protocols were compared using evaluation questionnaires among the participating parents and study personnel. Results: The parents found the questionnaires and instructions for filling in the food diaries understandable. Food description and food quantification was evaluated as problematic by 29 and 15 % of the participants for the 3-day diaries versus 15 and 12 % for the 1-day diaries. The protocol with 1-day food diaries was evaluated as less burdensome by the parents and logistically more challenging by the interviewers. Conclusions: Both dietary assessment methods with related tools and administration protocols were evaluated as feasible. The administration protocol with two 1-day food diaries with completion interviews offers more advantages for the future pan-European survey in children 0-10 years. The positive evaluation of feasibility of tools and materials is an important step towards harmonised food consumption data at European level among the younger age groups. [ABSTRACT FROM AUTHOR]

Purpose: We aimed (1) to describe and evaluate the 'EPIC-Soft DataEntry' application developed as a user-friendly data entry tool for pan-European and national food consumption surveys among infants and children, and (2) to compare two food record-based dietary assessment methods in terms of food description and quantification using data quality indicators. EPIC-Soft DataEntry was used for both methods. Methods: Two pilot studies were performed in both Belgium and Czech Republic in a total of 376 children (3 months to 10 year olds): one using a consecutive 3-day food diary; and the second with two non-consecutive 1-day food diaries with data entry during a completion interview. The collected dietary data were compared between the two dietary assessment methods by country and by age groups: (i) <1 year; (ii) 1-3 years; (iii) >3-10 years. Results: Overall, 70 % of the interviewers evaluated the work with EPIC-Soft DataEntry as easy. With both dietary assessment methods, an equally high proportion of specific food names (e.g., 'yoghurt, strawberry') were reported, where only between 5 and 15 % of foods were non-specified (e.g., 'yoghurt, n.s.'). The two 1-day food diaries yielded a higher proportion of foods with detailed description. For example, in the age category of 1-3 year olds in Belgium, for 7 out of 16 systematic questions on food description (e.g., 'preservation method,') specific answers were significantly higher (all P < 0.03). The proportion of missing quantities of consumed foods was comparable between the two methods. Conclusions: The EPIC-Soft DataEntry application was positively evaluated by the majority of the interviewers. Two non-consecutive 1-day food diaries with data entry during a completion interview provide a more detailed description of consumed foods as compared with a 3-day food diary. [ABSTRACT FROM AUTHOR]